Percutaneous liver cholangiography

It is mainly used in patients with obstructive jaundice to understand the location, scope and cause of biliary obstruction. Percutaneous liver puncture cholangiography precautions: 1. Avoid biliary hypertension caused by contrast medium injection, which can cause contrast medium and bile to leak into the abdominal cavity around the needle, causing local biliary peritonitis. Therefore, when the puncture needle enters the bile duct to extract bile, the bile should be withdrawn as much as possible to achieve decompression. If there is a pressure measuring device, the injection of contrast agent should not exceed the amount of bile withdrawn, and the bile should be drawn out first and mixed in a syringe, then slowly injected. After the radiography, bile should be withdrawn as much as possible. less. 2. Prevention and treatment of needle biliary blood fistula When puncturing into a large lumen, there is often a clear sense of emptiness. Suction should be performed immediately. Those who are easy to suck out blood prove that the needle tip is in the blood vessel. When entering the bile duct, ptcd should not be made from the original needle channel, and another puncture should be performed. 3. Avoid the effect of thick bile on the contrast during bile duct obstruction and infection, the bile viscosity increases, and it is not easy to mix with the contrast agent. In order to avoid misdiagnosis caused by thick bile, a small amount of physiological saline can be slowly injected for dilution, and then discarded and diluted. Repeatedly until the color of the bile fades, and the contrast medium is injected for imaging. If bile cannot be drawn out or diluted, it is not appropriate to perform an immediate radiography. You can insert a drainage tube 3 to 5 days later, and then perform radiography when the bile is diluted. 4. Pay attention to the concentration and uniformity of the contrast agent in the bile. The contrast agent is too thick, which can conceal the small stones.

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